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NPI Code Detail

MEDICARE: MISS CHERYL L WINNINGHAM B.S., I.S.

MEDICARE:  MISS CHERYL L WINNINGHAM  B.S., I.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care CoordinatorAR

General Provider Information

NPI Number : 1013190040
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS CHERYL L WINNINGHAM B.S., I.S.
Provider Business Mailing Address
First Line : PO BOX 558
Second Line :
City : CLINTON
State : AR
Zip : 72031-0558
Country : US
Telephone Number : 501-745-4584
Fax Number : 501-745-5921
Provider Business Practice Location Address
First Line : 2526 HIGHWAY 65 S
Second Line :
City : CLINTON
State : AR
Zip : 72031-6657
Country : US
Telephone Number : 501-745-4584
Fax Number : 501-745-5921
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2007
Last Update Date : 12/13/2007

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Directions to “ MISS CHERYL L WINNINGHAM B.S., I.S.” Practice Location

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